CPT 70486 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | • 23 - Emergency Room • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 70486 by major payers:
$172.59
$206.00
$247.42
$243.47
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 70486 | ||||||
United | 70486 | $324.17 | 1730190521 - AMY MUMBOWER | 741586031 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $259.42 | 1639165954 - ROBERT MAXEY | 901116751 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $97.44 | 1780683508 - HANNAH CHUNG | 870622942 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $329.27 | 1275633604 - EL PASO VAMC | 742934770 | TX | General Acute Care Hospital (282N00000X) |
United | 70486 | $356.70 | 1275633604 - EL PASO VAMC | 742934770 | TX | General Acute Care Hospital (282N00000X) |
United | 70486 | $155.61 | 1134265309 - MICHAEL LAM | 822718401 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $139.08 | 1205937547 - JEFFREY CARENZA | 760010407 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $131.66 | 1477549830 - NELSON UZQUIANO | 231742016 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $93.54 | 1376780866 - SERGY LEMESHKO | 720423889 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $123.34 | 1639165954 - ROBERT MAXEY | 862358048 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $141.72 | 1639165954 - ROBERT MAXEY | 862358048 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $683.03 | 1336186972 - DONALD SCHOMER | 760273984 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $70.22 | 1881981272 - EL PASO IMAGING CONSULTANTS PLLC | 273925303 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $184.11 | 1518120575 - ANTHONY ROWE | 811807730 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70486 | $48.43 | 1396779484 - JEFFREY GERIK | 741817345 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 70486 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 70486 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 70486 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 70481 | Moderate | Ct,Orbit,Sella,Fossa,Ear;W/Contrast |
| 70482 | Moderate | Computerized Axial Tomography Orbit Sella Or Posterior Fossa Or Outer Middle Or Inner Ear; Without Contrast Material Followed By Contrast Material(S) And Further Sections |
| 70486 | Low | Ct,Maxillofac.Area;W/O Cntrst Mat'l |
| 70487 | Low | C A T Maxillofacial Area; W/Contrast Mat |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 70486. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 70486 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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